Racial differences in the impact of smoking-attributable disease on health care costs in Indiana.

The purpose of this investigation was to estimate the direct health care costs attributable to smoking in Indiana and address these costs in the context of the differential health impact of tobacco use on minorities. Estimates of direct health care costs for smoking in 1990 were calculated using the Smoking Attributable Morbidity and Mortality and Economic Costs (SAMMEC 2.1) computer-based program developed by the Centers for Disease Control and Prevention. The proportion of direct health care costs attributable to smoking were calculated by evaluating personal health expenditures from five cost centers including hospitalization, physician services, services of other health practitioners, nursing home care and drugs. Study findings indicate that direct health care costs were more than $700 million in 1990. Health care spending among whites accounted for 53% of total costs. Per capita costs among smokers and nonsmokers > or = 35 years of age amounted to $278. Although whites accounted for the majority of direct health care costs attributable to smoking, per capita costs were higher among African Americans compared to whites, reflecting the differential smoking-attributable mortality rates experienced by these two groups.